<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">聚合支付平台订单号</label>
            <div class="layui-input-block">
                <input type="text" name="third_number" class="layui-input"  placeholder="请输入聚合支付平台订单号" value="{$row.third_number|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">支付系统订单号</label>
            <div class="layui-input-block">
                <input type="text" name="sys_number" class="layui-input"  placeholder="请输入支付系统订单号" value="{$row.sys_number|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">调用方订单号</label>
            <div class="layui-input-block">
                <input type="text" name="call_number" class="layui-input"  placeholder="请输入调用方订单号" value="{$row.call_number|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">第三方平台类型</label>
            <div class="layui-input-block">
                <select name="app_type" lay-verify="required">
                    <option value=''></option>
                    {foreach $notes['app_type'] as $k=>$v}
                    <option value='{$k}' {in name="k" value="$row.app_type"}selected=""{/in}>{$v}</option>
                    {/foreach}
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">appid</label>
            <div class="layui-input-block">
                <input type="text" name="appid" class="layui-input" lay-verify="required" placeholder="请输入appid" value="{$row.appid|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">商户号</label>
            <div class="layui-input-block">
                <input type="text" name="merchant_no" class="layui-input"  placeholder="请输入商户号" value="{$row.merchant_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">终端号</label>
            <div class="layui-input-block">
                <input type="text" name="term_no" class="layui-input"  placeholder="请输入终端号" value="{$row.term_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">拉卡拉对账单流水号</label>
            <div class="layui-input-block">
                <input type="text" name="log_no" class="layui-input"  placeholder="请输入拉卡拉对账单流水号" value="{$row.log_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">拉卡拉分配的商户号</label>
            <div class="layui-input-block">
                <input type="text" name="settle_merchant_no" class="layui-input"  placeholder="请输入拉卡拉分配的商户号" value="{$row.settle_merchant_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">拉卡拉分配的业务终端号</label>
            <div class="layui-input-block">
                <input type="text" name="settle_term_no" class="layui-input"  placeholder="请输入拉卡拉分配的业务终端号" value="{$row.settle_term_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">账户端返回信息域</label>
            <div class="layui-input-block">
                {:editor_textarea($row["acc_resp_fields"],"acc_resp_fields","账户端返回信息域")}

            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">接入方式</label>
            <div class="layui-input-block">
                <input type="text" name="trans_type" class="layui-input"  placeholder="请输入接入方式" value="{$row.trans_type|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">订单金额，分</label>
            <div class="layui-input-block">
                <input type="text" name="total_amount" class="layui-input"  placeholder="请输入订单金额，分" value="{$row.total_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">支付金额，分</label>
            <div class="layui-input-block">
                <input type="text" name="pay_amount" class="layui-input"  placeholder="请输入支付金额，分" value="{$row.pay_amount|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">结算类型</label>
            <div class="layui-input-block">
                <select name="settle_type" >
                    <option value=''></option>
                    {foreach $notes['settle_type'] as $k=>$v}
                    <option value='{$k}' {in name="k" value="$row.settle_type"}selected=""{/in}>{$v}</option>
                    {/foreach}
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">账户端业务信息域，存有用户标识，例如微信openid</label>
            <div class="layui-input-block">
                {:editor_textarea($row["acc_busi_fields"],"acc_busi_fields","账户端业务信息域，存有用户标识，例如微信openid")}

            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">订单状态</label>
            <div class="layui-input-block">
                <select name="status" >
                    <option value=''></option>
                    {foreach $notes['status'] as $k=>$v}
                    <option value='{$k}' {in name="k" value="$row.status"}selected=""{/in}>{$v}</option>
                    {/foreach}
                </select>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>
    </form>
</div>